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Individual

MIRRYIAN CLARISSA GRANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
671 HENDERSON DR, SENECA, SC 29678-1701
(864) 624-6922
(864) 467-3757
Mailing address
671 HENDERSON DR, SENECA, SC 29678-1701
(864) 624-6922
(864) 467-3757

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Enumeration date
01/23/2019
Last updated
01/23/2019
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